<form class="form-horizontal form-ajax" role="form" data-toggle="validator" method="POST">
  <!-- 客户名称 -->
  <div class="form-group">
    <label for="nickname" class="control-label col-xs-12 col-sm-2">{:__('Nickname')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="nickname" data-rule="required" class="form-control" name="row[nickname]"
        placeholder="{:__('Nickname')}" type="text" value="">
    </div>
  </div>

  <!-- 手机号码 -->
  <div class="form-group">
    <label for="mobile" class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="mobile" data-rule="required" class="form-control" name="row[mobile]" placeholder="{:__('Mobile')}"
        type="text" value="">
    </div>
  </div>

  <!-- 邮箱 -->
  <div class="form-group">
    <label for="email" class="control-label col-xs-12 col-sm-2">{:__('Email')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="email" data-rule="required;" class="form-control" name="row[email]" placeholder="{:__('Email')}"
        type="text" value="">
    </div>
  </div>

  <!-- 余额 -->
  <div class="form-group">
    <label for="money" class="control-label col-xs-12 col-sm-2">{:__('Money')}:</label>
    <div class="col-xs-12 col-sm-8">
      <input id="money" data-rule="required" class="form-control" name="row[money]" placeholder="{:__('Money')}"
        type="text" value="">
    </div>
  </div>

  <!-- 性别 -->
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Gender')}:</label>
    <div class="col-xs-12 col-sm-8">
      {:build_select('row[gender]', $GenderList, null, ['class'=>'selectpicker', 'required'=>''])}
    </div>
  </div>

  <!-- 客户来源 -->
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Source')}:</label>
    <div class="col-xs-12 col-sm-8">
      {:build_select('row[sourceid]', $SourceData, null, ['class'=>'selectpicker', 'required'=>''])}
    </div>
  </div>

  <!-- 认证状态 -->
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Auth')}:</label>
    <div class="col-xs-12 col-sm-8">
      {:build_select('row[auth]', $AuthList, null, ['class'=>'selectpicker', 'required'=>''])}
    </div>
  </div>

  <!-- 成交状态 -->
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Deal')}:</label>
    <div class="col-xs-12 col-sm-8">
      {:build_select('row[deal]', $DealList, null, ['class'=>'selectpicker', 'required'=>''])}
    </div>
  </div>

  <!-- 地区 -->
  <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">地区选择:</label>
    <div class="col-xs-12 col-sm-10 region_city">
      <input id="region" readonly type="text" data-toggle="city-picker">
      <!-- 用于提交数据把选中的地区传给后端处理 -->
      <input type="hidden" name="row[code]" id="region-code">
    </div>
  </div>


  <div class="form-group layer-footer">
    <label class="control-label col-xs-12 col-sm-2"></label>
    <div class="col-xs-12 col-sm-8">
      <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
      <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
    </div>
  </div>
</form>